实时三维超声心动图对两类不同病因心力衰竭患者左心室收缩同步性的临床研究  

Assessment of left ventricular systolic dyssynchrony in heart failure patients with two different etiology using real-time three-dimensional echocardiography

作　　者：寇红菊[1] 孙海燕[1] 黄品同[1] 田新桥[1] 黄福光[1] 林加峰[2] 孙微[1] 

机构地区：[1]温州医学院附属第二医院超声科,325027 [2]温州医学院附属第二医院心内科,325027

出　　处：《中华超声影像学杂志》2009年第6期492-495,共4页Chinese Journal of Ultrasonography

摘　　要：目的比较缺血性心脏病与扩张型心肌病两类病因引起的慢性心力衰竭（心衰）患者左室收缩同步性，并分析两组患者不同步性指数（SDI）与左室射血分数（LVEF）的相关性。方法43例心衰患者分为两组，A组为17例缺血性心脏病引起的心衰患者；B组为26例扩张型心肌病引起的心衰患者。应用实时三维超声心动图（RT-3DE）的全容积显像模式采集左室三维数据库，并用Qlab定量分析软件对其进行分析，获得左室舒张末容积（EDV）、收缩末容积（EsV）和左室射血分数（LVEF）、17节段“牛眼”图，16节段（除外心尖帽）收缩达最小容积时问的标准差并以心率校正后（Tmsv16-SI）／R—R）的百分数作为左室SDI。结果A、B两组人选患者的年龄、心率、LVEF和EDV差异均无统计学意义（P〉0．05）；A组的SDI略低于B组，但差异无统计学意义，17节段“牛眼”图显示两组患者左室收缩延迟节段的位置分布各有不同；对数回归分析显示A、B两组的SDI与LVEF均呈良好的负相关（r=-0．83，r=-0．71，P〈0．01）。结论缺血性心脏病与扩张型心肌病心衰患者左室均存在一定程度的收缩不同步，SDI与左室整体收缩功能存在负相关，随收缩功能的减低而增加，两组收缩延迟节段的位置分布各有不同。Objective To investigate left ventricular（LV） systolic dyssynchrony in heart failure of different etiology which caused respectively by ischemic heart disease and dilated cardiomyopathy and analyse the correlation between the systolic dyssynchrony index（SDI） and the LV ejection fraction（LVEF）. Methods Forty-three subjects were divided into two groups. Group A consisted of i7 heart failure patients which caused by ischemic heart disease and group B included 26 heart failure patients which caused by dilated cardiomyopathy. Three dimensional datum of left ventricle were obtained using real time three- dimensional echocardiography （RT-3DE） in full volume mode. Post-processing software Qlab was used for advanced analysis. The end-diastolic volume （EDV）, end systolic volume （ESV）, LVEF and bull eye graph of seventeen segments were obtained. Standard deviation of time-to-minimal systolic volume of 16-LV segments corrected by R-R interval was calculated as SDI of LV. Results There was no statistical difference in age, heart rate, LVEF and EDV between the two groups （ P 〉0.05）. SDI of group A was lower than that of group B, but there was no statistical difference between them （ P 〉0.05）. Bull eye graph of seventeen segments revealed that the distribution of delayed systolic segments were different between the two groups. SDI of two groups appeared negative correlation with LVEF（ r = -0.83, r = -0.71, P 〈0.01）. Conclusions LV systolic dyssynchrony existed in heart failure which caused by ischemic heart disease and dilated cardiomyopathy, but the distribution of delayed systolic segments were different between them. SDI increased with worsening LV systolic function.

关 键 词：超声心动描记术 实时三维 心室功能 左 心力衰竭 充血性 

分 类 号：R686[医药卫生—骨科学]